NPIMap

Individual provider Active NPI

Kimberly Lane Atwell, APRN

  • Adult Health Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1700330065
Registry record updated Aug 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
A004819 Issued in AR
Practice address
7 Shackleford West Blvd
Little Rock, AR 72211-3886
Phone
(501) 664-5860
Fax
(501) 664-0889
NPI assigned
Aug 4, 2016
Last updated
Aug 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X A004819 AR Primary

Addresses

Primary practice location

7 Shackleford West Blvd
Little Rock, AR 72211-3886

Mailing address

7 Shackleford West Blvd
Little Rock, AR 72211-3886
Phone (501) 664-5860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170104001094 AR Practitioner - Nurse Practitioner 8022399138 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healogics Specialty Physicians of Arkansas, PLLCGroup PAC ID 9739405408, 9 clinicians

Practice addresses (Care Compare)

620 W Grove St
El Dorado, AR 71730-4462
Phone (855) 689-5105

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A004819ARMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healogics Specialty Physicians of Arkansas, PLLC CurrentSince Dec 29, 2021 Accepting new patients
Arkansas Heart Hospital Rural Health Services, LLC CurrentSince Nov 5, 2016 Accepting new patients
Arkansas Heart Hospital, LLC CurrentSince Nov 5, 2016 Accepting new patients
Arkansas Heart Hospital, LLC CurrentSince Nov 5, 2016 Accepting new patients
Healogics Specialty Physicians of Missouri, LLC Past Accepting new patients

Locations

620 W Grove St
El Dorado, AR 71730
Phone (870) 862-0801

620 W Grove St
Ste 301
El Dorado, AR 71730
Phone (870) 864-5490

3017 N Bob Younkin Dr
Ste 102
Fayetteville, AR 72703
Phone (479) 463-4325

7 Shackleford West Blvd
Little Rock, AR 72211
Phone (501) 614-3671

5220 Belfort Rd
Ste 130
Jacksonville, FL 32256
Phone (904) 446-3686

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1700330065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SHACKLEFORD WEST BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113886",
            "telephone_number": "501-664-5860",
            "fax_number": "501-664-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 SHACKLEFORD WEST BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113886",
            "telephone_number": "501-664-5860",
            "fax_number": "501-664-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATWELL",
        "first_name": "KIMBERLY",
        "middle_name": "LANE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-04",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AR",
            "license": "A004819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.